Sheppard Kate
(Clinical Associate Professor), College of Nursing, University of Arizona, Tucson, Arizona.
J Am Assoc Nurse Pract. 2014 Sep;26(9):504-510. doi: 10.1002/2327-6924.12087. Epub 2013 Nov 21.
Deaf adults often experience significant healthcare disparities. This article gives voice to nine Deaf adults as they describe their lifelong experiences with health care.
Qualitative, hermeneutic interviews with nine culturally Deaf adults. Each participant was interviewed three times, aided by a certified American Sign Language interpreter.
Participants recalled childhood memories of painful and frightening procedures to investigate the deafness, which frequently overshadowed emotional needs. Communication barriers between Deaf patients and providers left the patients not understanding the diagnosis or treatment, medication use, or side effects. Descriptions included distressing or embarrassing interactions, and cries for help gone unanswered. Consequently, minimal health promotion occurs and most participants rely on the emergency department for health care.
Deaf patients should be screened for physical, sexual, and emotional abuse at every healthcare encounter. Assessments should include social support and social resources. Specific questions about pain, sleep, appetite changes, suicidal thoughts, and interest may help to identify manifestations of illness and health. Certified interpreters may be useful during the healthcare encounter, but ultimately the Deaf patient is best positioned to identify the most comfortable or meaningful means of communication between patient and healthcare provider.
成年聋人常常面临显著的医疗保健差异。本文讲述了九名成年聋人的经历，他们描述了自己一生的医疗保健体验。
对九名具有文化背景的成年聋人进行定性的诠释学访谈。每位参与者在一名认证的美国手语翻译的协助下接受了三次访谈。
参与者回忆起童年时因调查耳聋而经历的痛苦和可怕的程序，这些经历常常掩盖了情感需求。聋人患者与医疗服务提供者之间的沟通障碍使患者不理解诊断或治疗、药物使用或副作用。描述中包括令人痛苦或尴尬的互动，以及求助无人回应的情况。因此，健康促进活动极少开展，大多数参与者依赖急诊科提供医疗保健。
在每次医疗保健接触中，都应对聋人患者进行身体、性和情感虐待的筛查。评估应包括社会支持和社会资源。关于疼痛、睡眠、食欲变化、自杀念头和兴趣的具体问题可能有助于识别疾病和健康的表现。在医疗保健接触期间，认证翻译可能会有所帮助，但最终，聋人患者最有能力确定患者与医疗服务提供者之间最舒适或最有意义的沟通方式。
